Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PVS1PM2PP5_Moderate
The NM_000548.5(TSC2):c.5025delG(p.Leu1676TrpfsTer150) variant causes a frameshift change involving the alteration of a non-conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. Variant has been reported in ClinVar as Pathogenic (★). Synonymous variant affecting the same amino acid position (i.e. P1675P) has been classified as Likely benign. Variant results in nonsense mediated mRNA decay.
TSC2 (HGNC:12363): (TSC complex subunit 2) This gene is a tumor suppressor gene that encodes the growth inhibitory protein tuberin. Tuberin interacts with hamartin to form the TSC protein complex which functions in the control of cell growth. This TSC protein complex negatively regulates mammalian target of rapamycin complex 1 (mTORC1) signaling which is a major regulator of anabolic cell growth. Mutations in this gene have been associated with tuberous sclerosis and lymphangioleiomyomatosis. [provided by RefSeq, May 2022]
Verdict is Pathogenic. Variant got 12 ACMG points.
PVS1
Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 16-2087897-CG-C is Pathogenic according to our data. Variant chr16-2087897-CG-C is described in ClinVar as [Pathogenic]. Clinvar id is 50003.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr16-2087897-CG-C is described in Lovd as [Pathogenic]. Variant chr16-2087897-CG-C is described in Lovd as [Likely_pathogenic].
Review Status: criteria provided, single submitter
Collection Method: clinical testing
This sequence change results in a frameshift in the TSC2 gene (p.Leu1676Trpfs*150). While this is not anticipated to result in nonsense mediated decay, it is expected to disrupt the last 132 amino acid(s) of the TSC2 protein and extend the protein by 17 additional amino acid residues. ClinVar contains an entry for this variant (Variation ID: 50003). This variant disrupts a region of the TSC2 protein in which other variant(s) (p.His1746Pro) have been determined to be pathogenic (Invitae). This suggests that this is a clinically significant region of the protein, and that variants that disrupt it are likely to be disease-causing. For these reasons, this variant has been classified as Pathogenic. This variant is not present in population databases (gnomAD no frequency). This frameshift has been observed in individual(s) with clinical features of tuberous sclerosis complex (PMID: 9829910). This variant is also known as Phe1675fs. -